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OBJECTIVE To test the effectiveness of an evidence based model for management of depression in primary care with support from quality improvement resources. DESIGN Cluster randomised controlled trial. SETTING Five healthcare organisations in the United States and 60 affiliated practices. PATIENTS 405 patients, aged > or = 18 years, starting or(More)
BACKGROUND U.S. military ground forces report high rates of war-related traumatic stressors, posttraumatic stress disorder (PTSD), and depression following deployment in support of recent armed conflicts in Iraq and Afghanistan. Affected service members do not receive needed mental health services in most cases, and they frequently report stigma and(More)
OBJECTIVE To test the impact of physician education and facilitator assisted office system interventions on cancer early detection and preventive services. DESIGN A randomised trial of two interventions alone and in combination. SETTING AND SUBJECTS Physicians in 98 ambulatory care practices in the United States. INTERVENTIONS The education(More)
The COOP Project, a primary care research network, has begun development of a Chart method to screen function quickly. The COOP Charts, analogous to Snellen Charts, were pretested in two practices on adult patients (N = 117) to test feasibility, clinical utility, and validity. Patients completed questionnaires containing validated health status scales and(More)
The Study of Outpatient Referral Patterns was conducted in 1998 to examine the nature of the communication relationship between psychiatrists and primary care physicians regarding outpatient referrals. Nationally representative psychiatrists were surveyed (N = 542) regarding their aggregate experience with outpatient referrals from non-psychiatric(More)
Depression in primary care is a chronic disease. As with most chronic diseases, long-term adherence to treatment plans is problematic. Evidence-based systems of care address this problem, but persistence and dissemination of systems after testing is a new problem. The three-component model for the care of patients with depression is a system of widely(More)
BACKGROUND Recent trials have shown improved depression outcomes with chronic care models. We report the methods of a project that assesses the sustainability and transportability of a chronic care model for depression and change strategy. METHODS In a randomized controlled trial (RCT), a clinical model for depression was implemented through a strategy(More)
OBJECTIVE Depression is a prevalent high-impact illness with poor outcomes in primary care settings. We performed a systematic review to determine to what extent multifaceted interventions improve depression outcomes in primary care and to define key elements, patients who are likely to benefit and resources required for these interventions. METHOD We(More)
PURPOSE Postpartum depression is common but inadequately recognized and undertreated. Continuing depressive symptoms are associated with adverse outcomes for the woman, her infant, and family. We wanted to determine the effect of a practice-based training program for screening, diagnosis, and management of depression in postpartum mothers. METHODS In this(More)
OBJECTIVES To compare the Edinburgh Postnatal Depression Scale (EPDS) and Patient Health Questionnaire (PHQ-9) as screening tools for postpartum depression. METHODS This study population included the first 500 women to enroll and return their packets during an ongoing study of postpartum depression. RESULTS The primary outcome of this study was to find(More)